The patient tells the nurse, 'I thought I was just depressed, but my doctor says I have bipolar disorder. What is that?' What is the best response by the nurse?

Correct Answer: D

Rationale: Bipolar disorder features mood cycles-depression and mania (hyperactivity)-per DSM-5, distinct from unipolar depression. It's not just cyclic depression, nor ADHD-linked. Seasonal shifts are separate (SAD). Mania-depression cycles define it, clarifying diagnosis.

Correct Answer: A

Rationale: Penicillin G is a beta-lactam antibiotic that can cause severe allergic reactions, including anaphylaxis. Having epinephrine on hand is crucial for managing such emergencies. Collecting a culture and sensitivity before the first dose ensures the infection is caused by a penicillin-susceptible organism. Mouth ulcers are not a common side effect of penicillin, but monitoring for superinfections like oral thrush is important. Limiting fluid intake to 1000 mL/day is incorrect, as adequate hydration helps maintain renal function and prevents crystalluria. No particular interventions are required is incorrect, as penicillin requires careful monitoring for efficacy and adverse effects.

Correct Answer: B

Rationale: Prenatal vitamins likely caused iron overdose (bloody emesis). Deferoxamine chelates iron, preventing toxicity. Aminocaproic acid treats bleeding. Dimercaprol and Penicillamine target other metals. Succimer (E) is for lead. Deferoxamine is urgent for this child.

Correct Answer: C

Rationale: The ability of epinephrine to cause hyperglycemia is primarily due to its effect on alpha adrenoreceptors in the pancreatic islets of Langerhans. Epinephrine, acting through these alpha adrenoreceptors, inhibits the release of insulin from beta cells in response to elevated blood glucose levels. This results in decreased uptake of glucose by cells, leading to increased blood glucose levels, ultimately causing hyperglycemia. Other effects of epinephrine, such as vasoconstriction and increased heart rate, also contribute to the overall stress response, but the inhibition of insulin release through alpha adrenoreceptors is the main mechanism responsible for its hyperglycemic effects.

Correct Answer: A

Rationale: Patients with peptic ulcers should stop taking NSAIDs. NSAIDs, which stands for nonsteroidal anti-inflammatory drugs, can worsen peptic ulcers by increasing the risk of gastrointestinal bleeding and ulcer formation. NSAIDs work by inhibiting prostaglandin synthesis, which can lead to a decrease in the protective mucus production in the stomach lining, allowing gastric acid to damage the mucosa and exacerbate peptic ulcers. Therefore, it is crucial for patients with peptic ulcers to avoid NSAIDs to prevent further damage to the gastrointestinal tract.